Clinical Diagnosis And Analysis Of 42 Cases With Primary Gastric Lymphoma

Objective: To study the clinical characteristics in primary gastric lymphoma and analyze retrospectively the relationship between clinical factors and prognosis.Method: A total of 42 patients with primary gastric lymphoma who were admitted to Zhangzhou municipal Hospital from January 2010 to December 2013 were screwed.Clinical characteristic and the relationship between clinical factors and prognosis were analyzed By means of Kaplan-Meier's and the Cox model.Results: All patients were at the age of 27 to 84,with median age and the average age were 64 and 59.5 respectively.Thirty-four cases(80.9%)complained abdominal pain,20 cases(47.6%)with melena,12 cases(28.5%)with hematemesis,and 12 cases(28.5%)with fatigue respectively.Twenty-four cases(57.14%)of tumor were involved in gastric antrum or corpora ventriculi,17 cases(40.5%)in both sites.Ten cases(23.8%)were involved in corpora ventriculi and gastric,3 cases(7.1%)in corpora ventriculi and gastric cardia.1 case in gastric antrum and gatric angle.Eight cases(19%)were involved in three sites or more.Forty-one patients underwent gastroscopy,31 of whom were diagnosed with lymphoma.Twenty-six cases(61.9%)performed ulcer type,9cases(21.4%)in nodular type and 6 cases(14.3%)in diffuse infiltrative type.Major pathological type was diffuse large B cell lymphoma and MALT lymphoma,with 25cases(59.5%)and 15 cases(35.7%)respectively.31 patients received treatment,including surgery in 15 cases,surgery combined chemotherapy in 10 cases,and chemotherapy only in 16 cases.Of 26 patients receiving chemotherapy,10 patients received CHOP combination with rituximab.Twenty-seven cases(64.3%)survived while 15 cases(35.7%)died.Kaplan-Meier's survival analysis showed that the survival rate in 1,2 and 3 years was 76%,69% and 69% respectively.Single factor analysis by Kaplan-Meier's showed that age,hypoalbuminemia,LDH,?2-MG,and the pathological type were correlated to prognosis,the results of multivariate regression analysis By Cox model showed that age,hypoproteinemia and LDH are the independent prognostic factors.Conclusions: The clinical manifestations of primary gastric lymphoma are lacking inspecificity and the rate of missed diagnosis about gastroscope is high.Age,hypoalbuminemia and LDH are the dangerous factors that influence independent prognosis.